Provider Demographics
NPI:1265489579
Name:CHAPMAN, STEWART R (DC)
Entity Type:Individual
Prefix:
First Name:STEWART
Middle Name:R
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 W GORE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73501-3615
Mailing Address - Country:US
Mailing Address - Phone:940-322-2400
Mailing Address - Fax:940-322-1930
Practice Address - Street 1:2934 KEMP BLVD
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76308-1017
Practice Address - Country:US
Practice Address - Phone:940-322-2400
Practice Address - Fax:940-322-1930
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6050111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0884355-03Medicaid
TX8K9540OtherBLUE CROSS/BLUE SHIELD-TX
8B8846OtherMEDICARE PTAN
TXU42467Medicare UPIN